Provider Demographics
NPI:1417211574
Name:STRAHL, BENJAMIN ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ROBERT
Last Name:STRAHL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 BELT ST STE A
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:MD
Mailing Address - Zip Code:21863-1366
Mailing Address - Country:US
Mailing Address - Phone:410-632-2551
Mailing Address - Fax:410-632-2561
Practice Address - Street 1:201 BELT ST STE A
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:MD
Practice Address - Zip Code:21863-1366
Practice Address - Country:US
Practice Address - Phone:410-632-2551
Practice Address - Fax:410-632-2561
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001375122300000X
MD152671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist